New research evaluated the cost-effectiveness of a quality improvement program set up in 17 Midwestern community health centres participating in the Diabetes Health Disparities Collaborative between 1998 and 2002. All of the centres serve low-income people, who often have no insurance or money for medications. “Whether or not a program is cost-effective is the kind of question you ask after you’ve found that a program works,” said lead researcher, Elbert Huang, M.D., an internist with the University of Chicago.

The team set out to determine the economic value of those health gains by calculating the incremental cost-effectiveness ratio (ICER) for the program. Health economists typically deem an ICER between $50,000 and $100,000 per quality-adjusted life-year as cost-effective. In the first four years of the Diabetes Health Disparities Collaborative, the program’s incremental cost-effectiveness ratio was $33,386 per quality-adjusted life year.

“In other words, the money that you are spending is producing health at a good value. It does not mean that the program is saving money, it just means that the program is improving health at a reasonable cost,” Huang said. The researchers found a 0.35 average improvement in quality-adjusted life year.

“That suggests that on average a person’s life will be extended by about a third of a year,” Huang said. “It’s a combined measurement that accounts for both improvements in quality of life but also improvements in length of life.”

“For society, improving this group’s health is paramount,” he said. “If we project that out over the long term, it should reduce rates of blindness, end-stage renal disease and heart disease,” Huang said.